Donor-specific anti-HLA-Antibodies (DSA) have been shown to be associated with antibody-mediated rejection episodes and a poorer long-term kidney graft function. The impact of anti-HLA-antibodies without donor-specificity (non-DSA) is not clear and long-term data are needed.

In the underlying, retrospective study kidney transplant function over time was analyzed according to the existence of DSA (group A), non-DSA only (group B) and no HLA-Antibodies at all (group C). All patients were transplanted between 2007 and 2009 and had at least once yearly measurements of Luminex single bead HLA-antibodies, serum creatinine and proteinuria levels. Altogether 60 patients were included in the study, 20 per group. The progressive decline in kidney function was calculated by linear regression across all estimated glomerular filtration rates (GFR) measured from post-transplant year 1 onwards and expressed as GFR in ml per min per year.

The mean follow up period was 97 months. The mean decline in GFR was -3.4 ml/min and yr for the patients with DSA (group A), -1.4 ml/min and yr for the patients with HLA-antibodies without donor-specificity (group B), and -0.9 ml/min and year for patients without any detectable HLA-antibodies (group C). The difference in functional decline in GFR associated with antibody status was also seen in regard to the degree of proteinuria, measured at the time of last follow up in spot-urine. The mean protein excretion was 900, 800, and 300 mg per day for groups A, B, and C, respectively.

In conclusion, even non-HLA antibodies seem to be relevant for transplant function and show a moderate impact on functional decline over the long-term.

CITATION INFORMATION: Mueller T, Gerritsen K, van Breemen R, Ruesi B, von Moos S, Cippa P. Even Non-Donor-Specific HLA-Antibodies Are Associated with a Progressive Decline in Kidney Transplant Function. Am J Transplant. 2017;17 (suppl 3).

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